Newt my friend, how do you suppose those 100,000 Minnesotans’ medical bills have been paid up until now? You’ve been paying their bills in the form of cost-shifting, which leads to higher premiums for employers and premium paying Minnesotans. There is no free lunch.

I have a hard time with the anti-reform arguments that are founded in myth, such as the law increases the deficit, is a government takeover of health care, and is a job killer. The most credible sources on that subject clearly prove that those claims are false.

I CAN understand the philosophical argument that the government shouldn’t force people to buy anything, health insurance in this case. I think it’s a misguided philosophical concern, because you can’t hope to control health costs as long as people are free to delay purchasing coverage until they they are very ill. And I can’t see how a coverage mandate is unconstitutional, because health coverage and lack of health coverage clearly has a huge effect on commerce, and therefore is permissible regulation of interstate commerce. But at least that is a philosophical argument that is based on something that the law actually does do. And it definitely has political traction.

But to get the cost control benefits of health reform, you pretty much either have to have1) government mandated private coverage, as the new federal law does and Mitt Romney’s reform in Massachusets did, or 2) government run coverage, such as Medicare for all. Without one of those two things, cost-shifting and care-delaying will continue to limit all other efforts to control costs and improve care.

The CBO trashed the Democrats’ first few attempts at a fiscally responsible bill, refusing to agree that various technological improvements Democrats were making to the medical system – like electronic health records – would save the money Democrats said they would. That sent the disappointed Democrats back to the drawing board – and more than once. But they eventually came up with a blunter,surer financing strategy: About $500 billion in cuts and reforms to Medicare, and a similar amount in new taxes. It was proof that the system had worked: Democrats, despite knowing that the taxes and Medicare cuts would cause them great political pain, were so intent on getting the Good Housekeeping seal of approval from the CBO that they made their bill far more fiscally responsible.

This left the Republicans in a bind. If the Democrats’ legislation fulfilled its goal of covering almost every American and also managed to pay for itself, it was suddenly much harder to oppose. So last week, as the Republicans sought to make their case that the health-care bill should be repealed, a lot of their arguments were aimed at undercutting the numbers coming out of the CBO.

…Take Republican criticisms that the “doc fix” isn’t included in the CBO’s scores, and that if it were, the health-care bill would increase the deficit. It’s absurd. In 1997, congressional Republicans capped the rate at which Medicare could increase payments to physicians. But their cap was too low. Now they want Democrats to fix it for them and pile the costs onto the bill. It’s a little like saying that the cost of the war in Iraq should be added to health-care reform.

But you’ll notice it took a moment to explain that. It’s easier to just say that the score is full of “smoke and mirrors” and then make some authoritative-sounding point about Medicare payments. Who’s got the time to check it out?

You can play whack-a-mole with this stuff all day. But beneath it is something more insidious: an effort to discredit the last truly neutral, truly respected scorekeeper in Washington. The facts don’t support the particular case the Republicans want to make, so they’re trying to take down the people who supply the facts. But once that’s done, it can’t easily be undone. And the true loser will be the very thing Republicans claim to care most about: the deficit.

If getting the CBO’s seal of approval ceases to matter, then political parties will cease to try. That’s when the “smoke and mirrors” will really begin: when bills just have to sound good rather than pencil out. When there are no skeptical budget experts sending legislation back to the authors with a note that says “Sorry, not there yet.” When policy debates are decided by who can yell the loudest rather than who can write the best bill.

The bargain that both parties have struck with the CBO is that they’ll accept the short-term setbacks the agency imposes on them because, in the long run, it’s better for the system to have someone keeping score. Right now, Republicans are breaking that bargain. They’re not merely saying that the CBO’s guess is bad, or that the CBO is right but the bill is bad for other reasons, but that the CBO’s whole system is, in the words of Rep. Tom Price (R-Ga.), “Garbage in, garbage out.” Civil? Maybe. Wise? Definitely not.

Nice try on the Bachmann/Kennedy reference. Dr. Krauthammer wrote the column. I think it raises some valid points. And he’s hardly a reactionary. But go ahead, try to frame the debate any way that suits you. I attacked the CBO? At least you don’t exaggerate.

I know you have a biblical like faith in the CBO, but Krauthammer makes a good point. The CBO doesn’t supply “facts.” It tests the number given to them — by the lawmakers.

He’s right. It sounds good. I’m not arguing the numbers wouldn’t work. But you have to believe that all those cuts and assumptions will really happen. Therein lies the problem.

Mike, you agree with Bachmann about CBO and the deficit implications of health care reform, correct? That’s why I made that “Bachmann/Kennedy” reference in a sentence about that subject.

It’s not true that CBO accepts any assumption given. I worked for Congress for nine years, so this isn’t speculation. As Klein notes, the Democrats made a number of assertions about health reform cost savings that CBO rejected, and I have real questions with CBO’s decisions on some of those decisions. But that didn’t lead me to say CBO is no longer a valid congressional referee.

For example, electronic medical records. A lot of health systems in Minnesota and around the country are investing in these very expensive systems because they look to strong evidence from third party experts that shows electronic medical records will ultimately reduce costly medical duplication and errors and drive providers toward evidence-based best practices, from a quality of care and cost effectiveness basis. Those private health systems firmly believe the evidence is strong that electronic medical records reduce costs. But CBO apparently disagreed and didn’t score the claimed savings.

So the assertion that a Member of Congress can just say to CBO “I say provision X saves $Y billion” and they will score it that way is false.

CBO is like the refs at my high school son’s basketball games. Correct most of the time, and much more often than I like to admit in the heat of the battle. But they’re obviously not perfect, because no human can be. But the refs are the entity that both sides have mutually agreed should guide the process, because they are as prepared and objective as any human can be. If the kids and coaches denied their referees’ expertise, authority and objectivity, and therefore rejected their decisions, there would eventually be fights on the courts and in the stands. That’s what concerns me about this trend of bashing CBO when you don’t like a call that they make.

Over the past year, Bachmann has often criticized President Barack Obama, the newly enacted health care law and the growing federal deficit. She comes armed with assertions, figures and graphs to make her point.

But independent fact checkers find that the information she relies on is often exaggerated, misleading or wrong. PolitiFact, a Pulitzer Prize-winning feature of the St. Petersburg Times that checks whether statements made by politicians are true, has repeatedly determined that Bachmann’s claim don’t ring true.

“We have checked her 13 times, and found seven of her claims to be false and six have been found to be ridiculously false,” PolitiFact editor Bill Adair said.

Adair said no politician has been checked as often as Bachmann without saying at least something that’s true.

“I don’t know anyone else that we have checked, more than a couple times, that has never earned anything above a false,” he said. “She is unusual in that regard that she has never gotten a rating higher than false.”

Adair is careful to say that he expects to someday fact check a Bachmann statement that turns out to be true.

OK, so the CBO doesn’t accept EVERY assumption given. Yes, it challenged the electronic medical records assumptions, but that’s because the numbers were off so wildy that few could agree — anywhere from $12 billion over 10 years to $200 billion. That’s quite a range.

The fact remains that the CBO takes the assumptions it is given and then provides an outlook based on that information.

Of course the numbers they are basing their conclusions on CAN work. I didn’t dispute that. What I dispute (and I’m hardly alone) is that it will ACTUALLY happen.

You can make numbers work on paper but that doesn’t mean they will work in reality. I saved this piece from nearly a year ago to see what if anything would change.

The CBO is less like a ref during a game than a forecasting entity. It is basing its conclusions on assumptions and how those assumptions, if correct, will play out in the future. But it has no control over whether those assumptions are actually come to pass.

Brian will also be pleased to know that the Columbia Journalism Review (CJR) chided the Star Tribune for not scrutinizing Bachmann, a point he has long been pressing. Minnpost’s Brauer, who also has also been making this point, quotes the CJR piece:

Mid-story, the Tribune reports, in passing, that “Democrats deride [Bachmann] as… factually challenged.” (I’m just passing along some other politicians’ claims about the veracity of this politician’s claims. Yes, I’m a reporter from Bachmann’s home state so I should be in a particularly good position to tell readers whether “factually challenged” is a fair description of the Congresswoman or just an unfounded Democratic dis. But, moving on….)

Well, of course the CBO is offering projections, and of course it can not tell the future, and of course there is no possible way to tell if what it is predicting is likely to happen BEFORE THE FACT.

Come on, you are in the investment business–you know all of this, and have to endlessly repeat it to all of your clients (otherwise they might sue you if things turn out differently).

But the CBO really is more like a referee–and also a forecasting firm. Sure, it has to assume that certain things will come to pass–we are talking about writing laws here, and it assumes that if Congress writes a law, the law will be obeyed–after all, that is what is supposed to happen with laws. It would be ridiculous on the face of it for the CBO to assume that a law will not be obeyed, or that another law MIGHT be enacted later that might change things–that way lies madness! The infinite regress of a house of mirrors!

I am not saying that your criticisms are not valid–but they are not valid criticisms of the CBO. Certainly, all of those things could happen, and it is always a good thing to note that Congress can pass a law and then change its mind. But that is always the case, and there is NOTHING that the CBO can do about that, and to state it is like stating that the sun will probably come up tomorrow, but maybe not.

The CBO judgement is the best that there is. Sorry you do not like it. Sure, it almost certainly will not reflect the reality of 5 years into the future, but then nothing else does, either. It is entirely possible that another prediction will do a better job of reflecting that reality that is yet to be, but that is because that more accurate prediction will get the political predictions right, and the CBO is supposed to NOT DO POLITICAL PREDICTIONS.

Yes, I do know how projections work. It’s why I don’t offer them on any type of investment. They are unlikely to materialize, just as I don’t offer projections on any market index or the economy. Christ, am I boring.

Mike: Ok, so non-partisan CBO forecasts are obviously fallible. So what do you do propose to do differently because of that?

A) Use NO forecasting to guide national budgeting and policymaking?
B) Have Republican forecasters and Democratic forecasters instead of the CBO non-partisan forecasters and let the party in power control the forecasting?
C) Rely on the forecasting of Reason, who you cited earlier and whose mission is, unlike CBOs, to promote a particular political viewpoint?
D) Treat CBO situationally…quote them as the Gospel when you like their decision but overrule them with ideological think tanks and columnists when you don’t like their decision?
E) Other?

All of those options strike me as problematic.

It’s easy to tut tut about forecasting being imperfect every time CBO doesn’t support your political viewpoint, but what is your suggested alternative to the current use of a system of non-partisan CBO forecasting to guide national budgeting and policymaking?

My suggestion isn’t to rely on any one source as the definitive answer.

The reason I bring this all up is because I think the whole matter of financial forecasting should have received a wake up call with the financial crisis.

We had models being used by government regulators, Wall Street investment banks, government sponsored entities, commercial banks and everyone else that never modeled the worst case scenarios.

Those scenarios were “outliers” that were so unlikely to happen they weren’t even considered.

It just so happened that they were all wrong. Now I’m willing to wager there was a whole lot more brainpower there in terms of bodies and brains than just the good folks at the CBO.

Rather than accept the best case scenarios and model those, why not also have an honest discussion about the worst case scenarios and model those as well?

National policy is too often based on rosy projections that somehow, never happen to materialize or get vastly understated.

I don’t know how I can be any more clear about this, but I’ll try:

I’m not saying the CBO is bad. I’m saying let’s have an honest discussion about policy that will affect every American and makes up about 20 percent of our economy. And let’s look at what we would do as a backup plan if the numbers turn out to be bogus.

Mike my friend, I’ll make a final comment and then drop it. We’re not likely to enlighten each other, and even I am boring myself with my blatherings.

Re: “My suggestion isn’t to rely on any one source as the definitive answer.”

A forecaster smorgasbord would seem to split the baby and please everyone. But as a practical matter, it just can’t work.

Under your forecaster smorgasbord scenario, Congressman Loveland would surely go to Families USA or the Center for American Progress for his learned budget estimate and Congressman Kennedy would surely go to Reason or CATO for his sterling budget estimate. Each of us would show charts and data tables about why our numbers are better, and each of us would feel oh so self-righteous.

But for the purposes of planning and informing colleauges and constituents, how would you score it in the budget, Congressman Loveland’s way or Congressman Kennedy’s way?

As PM said, you do have to have a final trusted nonpartisan numbers cruncher who makes the final call in the same way a referee with no allegiance to either team makes a final call. Just because even the world’s best referee still makes errors, doesn’t justify either not having referees or allowing each team to shop around for their own referees.

Out of sheer practicality, you must mutually agree to trust a single go to numbers cruncher that both sides agree will referee the game. This is not to say that you shouldn’t always work to make sure the ref is as well trained and free of bias as possible, but it is to say that going without a ref or making a diehard fan into a ref are both much more problematic scenarios than having a ref with human limitations.

At last count, I think 26 states are challenging the legislation. Look out if this gets to the Supreme Court. It will be a 4 to 4 vote more than likely with a wild card justice casting the majority opinion.

I understand at least three justices won’t be at the state of the union because of the comments made last year — or maybe they are just out of town.

(seriously, i thought that this was actually a good commercial–perhaps a bit ominous, but that will probably play well with Iowa Republicans, and sort of serves to address the weakness T-Paw has on national security)

Thinking about the video overnight, it brought me back to one of my favorite books, “Amusing Ourselves to Death” by Neil Postman, which explored the impact of America’s transition from a words-and-text-based communication culture to a culture in which the dominant medium of communication was television — flickering images accompanied by mood music and laugh tracks.

In general, communication — especially political communication — via the printed word is under some pressure to be about something that can be supported by facts or rebutted by others, analyzed rationally and tested logically. With text, you can slow down to read something carefully and think about it as you do. And, Postman argued (and I bought it) that information that comes into body through typography is much more of a brain exercise, compared to images and sounds that work in unseen ways on your emotions.

…in the age of flickering images, facts, logic, argument, analysis are diminished until we get a little film like this one. It has no facts, no argument more concrete than “if freedom were easy, everyone would be free. But we can do it, because we’re America.” But even that is Aristotelian compared to the main “message,” which is carried by the images.

Beyond Dayton appealing to his base on health reform, triangulation seems to be in the air. Yesterday, Governor Dayton ordered regulatory streamlining. Tonight, President Obama is ordering an earmark ban and five year discretionary budget freeze. Somewhere Dick Morris is smirking.

Geez Joe, the real value of this posting here is found in your comments!

Even Bachmann has been taught to ‘hate the sin not the sinner’, yet you wrote this Ali v Frasier virtually empty of content thrilla in manila posting…and when I clicked in to tell you so, luckily I read the comments first and finally found out why I should care versus why I should complain.

As a social/commentary experiment, you should consider redoing your posting with the much better content of your comments to see if the entire posting is received better.

Hi Other. Thanks for the comments. This is a blog that promises in our banner to be about “ruminations and fulminations about communications,” and not, much to my disappointment, “Joe’s pontification about politics.” So in the up-front posts I try to at least somewhat keep that promise, and comment about the strategic and tactical nature of the communications maneurvering du jour, as opposed to my opinion on the content. I know that feels too horse racey to a lot of our readers, but that’s a big part of what this blog is designed to be.

In the comments section I usually lapse into personal sermons, but the up-front post is often about the communications chess game, rather than primarily about my ideology.

Thanks for your participation, and the opportunity to explain the method of my madness…